HIV infected patients in c.h.u. oran and cryptococcal meningitis
Zakaria Benmansour
University of Medicine, Algeria
: J Immunol Tech Infect Dis
Abstract
Cryptococcal meningitis in HIV-infected patients is an important fungal pathogen in immunocompromised patients. A retros pective study was conducted to investigate the occurrence of Cryptococcus neoformans infection in patients admitted to the unifes of deseas infections over one year-period. During this period, cryptococcal meningo-encephalitis was diagnosed in 23 individuals. The median age of the patients under study was39.25 years. There was a male preponderance in our report. Typical presentations were persistent headaches (27 cases/36), neck stiffness (16/36), alteredconsciousness (14/36), fever (12/36) and convulsions (9/36). . High mortality was related to delayeddiagnosis. Cryptococcal meningitis highly contributes to mortality in HIV-infected patients and it may occur in patients not severely immunocompromised patients. A need exists to improve strategies for clinical management of AIDS patients Materials and Methods: Between January, 2013, and juin2014, on 1099 takings send in the service of parasitology among which 201 LCR, 23 cases of cryptococcose. Results: Prevalence of the meningo-encephalitis cryptococcose at the patients infected by the HIV was 0, 4 %. His (her, its) frequency practically decreased while it was 2, 09 %for the ten years. The average age of the patients was 36 ± 4, 5 years old. Discussion: The man is preferentially touched. The average deadline (extension) of evolution of the symptomatologie before hospitalization represented one week. The mode of installation of the disease is progressive with not specific clinical signs, fever, headache, generally frontal, temporal or retro - orbitaires and resistant in the analgesic, It is necessary to keep in memory that to At a severely immunosuppressed patient, with a rate of CD4 lower than 200 by mm3, any suspicion of meningitis has to make look for a cryptococcose, these figures found allowed to review the evolution of this pathology in region Only Algerian West the isolation of the cryptocoque in the cerebrospinal fluid allows to assert the diagnosis of neuromeningeal cryptococcose with certainty. The main cytochimiques anomalies some cerebrospinal fluid (LCR) were the hyperprotéinorachie (95, 4 % of the cases), the hypoglycorachie (91 %) and the hyperlymphocytose (100 %). The search (research) for Cryptococcus neoformans in the LCR in the direct examination after tint (coloring) in the India ink has 100 % specificity and a very big sensibility. The search (research) for Cryptococcus neoformans Was positive in 72, 7 % of the cases and after culture on environment (middle) of Sabouraud added of chloramphenicol in every case (100 %). An evolution most of the time mortal, in this study the death arose in 54, 5 % of the cases. Conclusion: the fight(wrestling) against the neuromeningeal cryptococcose necessarily has to cross(spend) by the systematic search(research) for this affection to the subjects HIV + presenting headaches, the prescription of effective systematic antifungals and by a primary prevention resting(basing) on an extension of the access to antiretrovirals
Biography
Zakaria Benmansour is a doctor in University of Medical Sciences “ Oran Algeria On Parasitology and mycology medical Laboratory “of The University Hospital, Oran. He is a researcher in the laboratory of infectious diseases and biologically active substances in the faculty of medicine of Oran, Algeria and head of department of Parasitology and Mycology . His research work focuses on molecular fungal, virology and vaccinology. He completed Ph.d.in parasitology and mycology, department of medicine of Oran Algeria. His research included work on mycology and parasitology infections.
E mail:benzakarion31@YAHOO.FR
